A Frightening Experience

I spent most of this weekend involved in activities related to the New York City Marathon. The marathon proved to be remarkable, coming down to a sprint to the finish on the men's side, with Paul Tergat of Kenya winning by the slimmest of margins over a stumbling Hendrick Ramaala of South Africa. The women's race was won by Jelena Prokopcuka of Latvia. Among Americans, Meb Keflezighi and Abdi Abdiramam finished third and fifth respectively; while on the women's side, Jen Rhines finished eighteenth.

On this day that was too hot for most runners, I was working at the race. In the evening, one of my teammates, an older man, was walking it in, and I joined him in order to hook up with the rest of my team. After he finished, he felt light-headed, and took some water and a granola bar. We got his bag and tried to get him attention for a blister on his foot. The medical tents had closed by this time, and the EMT's were prohibited from popping the blister (ain't bureaucracy wonderful?). As the EMT's were leaving, he got up to begin the trip out of the park and dropped like a stone. A quick shout got the EMT's back and doing the things they could do. Thus began a brief odyssey into the world of medicine.

I have to say that the level of professionalism exhibited by the ambulance crew was superb. They lifted him onto the stretcher, strapped him in, and got him up to to location with the ambulances. They'd taken his blood pressure immediately on getting him onto the cart. When they got him up to the ambulances, we gave him (with permission) Gatorade to try to replenish his fluids, sugars and electrolytes. Upon getting him up to the ambulances, they again took his pulse and blood pressure. They then asked if he wanted to be transported to a hospital. My friend declined. Everyone was taking their time (he seemed in no danger, and everyone seemed to recognize that time and appropriate fluids would likely do the trick) and after a few minutes rest and about 12 oz. of Gatorade, he got the "you're being released against our recommendation" also known as the CYA warning (thus, covering the butts of the ambulance crew if anything was more seriously wrong), was told that if problems persisted, he should call 911, and was released.

A very slow trip down the subway stairs began the long trip home. In the station, a cop told us (as participants and volunteers) to use the gate for free entry into the subway. Timing meant that we had most of an hour to pass in Penn Station before our train out of the city. As a result, we got some fast food for dinner, further allowing him to replenish his body, and by the time to go down the steps to the train, he was fine aside from the normal weakness that 26+ miles in your legs will cause.

Discussion after the fact indicated that he'd taken only water on the course. I was a bit surprised, as so much press has been given to the risks of hyponatremia. I gave the take ade or alternate ade and water lecture to him. When he went down, it was a bit frightening, partially because he dropped so fast and partially because I've heard too many stories of needless deaths at marathons and similar events.

The lesson: Take your sugars and electrolytes during the marathon to minimize any problems. From experience, I can tell you that since I started taking ade and using gels during marathons, I've never hit the wall. I don't know if that's enough to say it will prevent it, but it likely helps.